Is it best to have a cesarean section for a scarred uterus?

A scarred uterus is a uterus that is scarred by damage to the female uterus. It is usually caused by a cesarean section. Scars on the front wall of the uterus due to a cesarean section, or scars left by uterine fibroid surgery are all considered scarred uterus. It is best to wait 3-4 years before having a cesarean section again for a scarred uterus. If the uterine scar is not healed well, the uterine wall will become thinner, which can be life-threatening.

Uterine scar: Caesarean section is best for life

When preparing to have a second child, you must grasp the time well. It is best to have more than three years. The better the uterus recovers, the lower the risk to the mother. Before getting pregnant again, you should do various prenatal examinations, have regular prenatal checkups during pregnancy, and seek medical attention promptly if there are any abnormalities.

What is a uterine scar?

A scarred uterus, also known as a scarred uterus, refers to a uterus that leaves scars after an injury. Uterine scarring does not necessarily occur in women with a scarring constitution, but most commonly occurs in mothers who have undergone cesarean section. Because a cesarean section requires an incision in the lower part of the uterus, a scar will form on the anterior wall of the uterus. In addition, women who have undergone gynecological and obstetric surgeries such as myomectomy, uterine perforation or rupture repair, and metroplasty are prone to developing uterine scars.

Pregnancy and childbirth for mothers with uterine scars are more dangerous than for normal mothers. Doctors generally recommend that mothers who have had a cesarean section consider getting pregnant again two years after giving birth, because a scarred uterus will form after a cesarean section. If a mother becomes pregnant when the uterus has not fully healed, the fetus will develop, the uterus will enlarge, the uterine wall will thin, and the connective tissue at the cesarean section incision will lack elasticity. The fresh scar can easily rupture in the late pregnancy or during delivery, causing massive abdominal bleeding and even life-threatening.

Women with uterine scars do not have any special characteristics. Some women may experience painless vaginal bleeding and abdominal pain. Clinically, the examination is mainly based on ultrasound. Therefore, when a mother experiences similar symptoms in her daily life after a caesarean section, it is best to take it seriously and go to the hospital for examination as soon as possible. If a mother with a uterine scar becomes pregnant again, she can only choose vaginal delivery if she meets the indications for natural birth.

Causes of uterine scarring

The cause of uterine scar is mainly related to the poor recovery of the uterus after cesarean section. There are many factors in life that can affect the healing of cesarean section uterine incisions, and each mother has great individual differences. The causes of uterine scar can be roughly divided into the following aspects:

1. Malnutrition during pregnancy: If malnutrition, severe tissue edema, hypoproteinemia, anemia, etc. occur during pregnancy, timely increase in nutritional supplements after delivery may also affect the healing of the incision and form a scarred uterus.

2. Infection during surgery: If infection occurs during the cesarean section, the incision will be difficult to heal in stage I, the incision scar will be large, and a scarred uterus will be formed. At this time, the uterine fibers are less elastic and are more likely to rupture during the next pregnancy, which can be life-threatening.

3. Whether the surgical suturing process is normal. When suturing during cesarean section, whether the anatomical relationship is accurately matched and the suturing is appropriate. If the lower transverse incision is bluntly torn open, the edges are then neatly aligned, sutured appropriately, local blood supply is good, and the incision heals well, it is not easy to form a uterine scar.

In addition, it should be noted that different cesarean section surgical methods can cause uterine scarring. For example, cesarean section can be divided into classical cesarean section (incision beyond the navel) and lower uterine segment cesarean section. The lower segment incision has different surgical methods such as horizontal incision and vertical incision. The incision healing effects of these surgical methods are different, and the scars formed are also different. The longitudinal incision on the body severs the transverse muscle fibers, causing severe damage, and the wound will not heal as well as the transverse incision on the lower segment. For example, whether the myomectomy is performed on a single nodule or multiple nodules; whether the depth is the entire layer of the uterine wall or limited to the serosa layer, and the scars formed are also different.